Pediatric Occupational Therapy, Teaneck, Bergen County, Englewood » 2009

POTS Blog

Stick to the beat!

Monday, March 23rd, 2009

Use of a digital metronome to facilitate rhythmicity, coordination and organization has become a part of many treatment sessions at Pediatric Occupational Therapy Services (POTS). Many parents have purchased them and are using them to implement home programs under the guidance of their occupational therapist. So what exactly is this pocket sized “toy” that makes different sounds, and what are the benefits to using it?

What is a metronome?

The metronome is used to keep a steady beat. It can typically be programmed to a speed ranging from 40 bpm (beats-per-minute) to 208 bpm.
It is often used by musicians to help improve their rhythm, timing, and speed.
There are several different versions of the metronome, from the classic mechanical one to the more sophisticated pocket or computer generated variety, each with varying features. Check out the POTS recommended Korg MA-30 Ultra Compact Digital Metronome at www.amazon.com, or look for it at your local music store. The Korg has a visual display and the sounds can be made louder or softer, depending on the needs of your child.
At Pediatric Occupational Therapy Services we have been using the computer-based Interactive Metronome (Advanced Brain Technologies; www.advancedbrain.com) as a comprehensive office-based treatment modality since 2002. The digital metronome has enabled us to harness the power of rhythmicity and incorporate it into daily sessions and home programs as well.

What goals can the metronome help my child achieve?

What are some activities that he/she can do with the metronome at home?

There are numerous activities that can be performed with a metronome. With each activity, pick a specific speed. Anywhere between 40 and 60 bpm is a typical starting point, but check with your therapist first to determine what speed is the most appropriate for your child.

Try doing the following activities “to the beat”:

Clapping with both hands
Stomping with both feet
Jumping with both feet together
Jumping on one foot
Clapping and stomping hands and feet simultaneously
Hitting a target (make one out of a piece of construction paper) on the wall with your hands
Hitting a target on the floor (a colored dot) with your feet
Throwing a ball back and forth to another child with or without bouncing it
Throwing a ball against the wall with or without bouncing it

To increase the challenge, try activities that require crossing the midline of the body to facilitate bilateral coordination:

“Cross Crawl”: Alternate touching your right hand to your left knee and your left hand to your right knee
Alternate touching a target to the left with your right hand (yellow dot) and a target to the right with your left hand (red dot)
Hand games such as “Miss Mary Mac” and “Patty Cake”

When performing activities, look to see if your child tends to be hyper anticipatory (follows the beat too early) or hypo anticipatory (follows the beat too late). Help your child stay on the beat by having them count out loud and/or close his/her eyes. Do the activities together with them to help get them going.

Encourage your child to be creative and think of new and fun ways to use the metronome themselves.

By: Rachel Romanoff, MS, OTR/L & Chaye Lamm Warburg, MA, OTR

This entry was posted on Monday, March 23rd, 2009 and is filed under Boost Gross Motor Coordination & Rhythmicity, Sensory Integration.

Touch and Feel

Monday, March 16th, 2009

Some pre-school age children love to get dirty, and will touch just about anything and everything to explore its texture and feel. Children who are tactilely defensive however, may find playing with materials such as glue, sand, and soil in the classroom to be particularly frightening and will either avoid messy play or minimize contract with the offending substance. It is important for children to manipulate different textures with their hands and fingers in order to strengthen and develop the muscles used for handwriting and other fine motor tasks. Here are a few suggestions to help a tactilely defensive child better tolerate and explore his/her environment.

Before any activity involving touch, prepare your child by telling him/her what materials will be used in the activity. Explain that he/she can start by touching something with one finger only. As he/she gets more comfortable with it, he/she can then touch it with two fingers, then with the whole hand, etc.
Give your child disposable gloves to put on before the activity. This will allow him/her to explore a texture and exercise hand muscles without it directly touching his/her hands. Some disposable gloves come with different scents such as strawberry and grape (http://www.superduperinc.com), which can help make the activity more enjoyable.
- As your child begins to tolerate a specific texture while wearing gloves, have him/her snip off one fingertip at a time on the glove to gradually expose each finger to the material. You may end up snipping off all of the fingertips, or eventually removing the gloves altogether.
Have your child stick one or both of his/her hands inside a small Ziploc bag so that he/she can play with something without directly touching it.
Use other implements, such as cookie cutters or a rolling pin, when manipulating textures such as Play Doh or baking dough. Use a Popsicle stick to spread glue and shovels to plant or look for salamanders.

Share these suggestions with you child’s preschool teachers.

Blog by Rachel Romanoff, OTR & Chaye Lamm Warburg, MA., OTR

This entry was posted on Monday, March 16th, 2009 and is filed under Sensory Integration.

Costumes and Carnivals: Be Prepared!

Sunday, March 8th, 2009

The holiday of Purim is right around the corner, and your kids are itching with excitement. Children who rely on routine and predictability, such as children with sensory modulation disorders, may become overwhelmed on Purim, especially at a loud party or carnival filled with people in all kinds of costumes. Here are a few suggestions to help make your child’s holiday experience more enjoyable.

Costumes:

A child’s idea of dress-up may be different from an adult’s. It is perfectly fine if your child only wants to wear a hat or a funny mask. Do not force him/her to wear something he/she is not comfortable with.
A young child may find some costumes frightening, even/especially that of a clown. Prepare him/her in advance by playing dress-up or reading books about clowns or dressing up. The best clown parties are when the clown gets dressed and puts on their make-up in front of the children.
Try to involve your child as much as possible in planning his/her costume. Let him/her pick it out or help make it. But don’t be disappointed if he/she rejects it at the last moment.
Before wearing a costume, practice putting it on and taking it off a few times. This will help your child tolerate the feel of the costume and get a sense of how it looks visually.

Carnivals:

Prepare your child in advance by telling him/her where the party will be, who will be there, and what activities the party will include.
Let your child know that there will be people in costumes at the carnival. If he/she is afraid of certain costumes, try to play dress-up beforehand.
Try to arrive at the party early, when there are fewer people and less of a commotion.
If visual novelty or noisy environments tend to overwhelm your child, pick a “safe spot” where he/she can be encouraged to go if he/she needs a break from sensory overload.
Expectations should be realistic. It may be better to spend a successful 30 minutes at the carnival rather than buying handfuls of tickets and staying for an unsuccessful two hours.

Acknowledge to yourself in advance that you may need to spend more time helping your child than other parents. It may be daunting, but it will make the experience all the more manageable and enjoyable for both you and your child.

By:

Rachel Romanoff, OTR

Chaye Lamm Warburg, MA, OTR

This entry was posted on Sunday, March 8th, 2009 and is filed under Seasonal Tips.

Winter wonderland

Thursday, March 5th, 2009

The winter season is in full swing, and we have already had our fair share of snowfall. It may be warmer and more comfortable to stay inside, but the snow is a great tool to improve sensory integration, strength, and fine and gross motor skills. So put your boots on, bundle up, and try some of these fun activities in the snow!

Snowman: Pick up large piles of soft snow with both hands and roll them into small and large circles to make a snowman’s body and head. Use pieces of food such as raisins and a carrot for the snowman’s eyes and nose. Use eyedroppers (a fine motor skill) or a spray bottle (to develop upper body strength) and squeeze or spray drops of food coloring on the snowman to give him/her some hair. Plan your snowman in advance to encourage sequencing and organizational skills. Be creative and make snow animals too, such as dogs, squirrels, and rabbits. Line up three snowballs to make a worm or caterpillar.
Snow Hop: Pretend to be an animal such as a bunny rabbit and jump with both feet together across the snow. Try jumping to a beat to help develop rhythm and coordination. Have relay races.
Snow Messages: To reinforce letter formation and strengthen balance, practice writing letters or numbers by dragging your feet through the snow. Write messages such as “Hi Mom” or “I Love Snow.” Later on, you can go to the top floor of your house and look at your work!
Snow Forts: To strengthen postural control and the upper body, fill up several big containers or buckets with snow. Then empty them upside down. Keep adding to the pile to build the wall to your fort. Build a few walls and, if there is enough snow, make some tunnels to travel from fort to fort.
Snowflake catch: To improve visual tracking, look up to the sky and try to catch as many snowflakes as you can on a black piece of construction paper. See if you can make a cool design with them. You can also try to catch snowflakes with your tongue!
Snow Angels: This is a great activity to develop body awareness. Lie on your back in the snow and move your arms and legs up and down to create a snow angel. Try making other snow imprints with your body, such as an airplane, and have others guess what you made.
Snowball maker: The snowball maker is a great toy for making snowballs and improving bilateral coordination. Choose from a variety of colors at www.landofnod.com, keyword “Snowballer”.

By: Rachel Romanoff, OTR & Chaye Lamm Warburg, MA, OTR